[Sexual and reproductive health in young men in Chile: results of a qualitative studySaúde sexual e reprodutiva de jovens do sexo masculino no Chile: resultados de um estudo qualitativo]

[Knowledge, access and use of the health system by migrant adolescents in Chile: results of an exploratory study]

OBJECTIVE

To identify the knowledge, access, and use of the health system by migrant adolescents, and the barriers to access and use of the health system in that population in Chile.

METHODS

Observational, cross-sectional exploratory study applied in a participatory workshop with migrant adolescents (N=30) in three municipalities of the city of Santiago, Chile. Multimethods study. A baseline survey on the migration process and experiences in the health system was applied, with descriptive data analysis. From the qualitative point of view, discussion groups (n=5) and participatory workshops (n=2) were carried out with migrant adolescents.

RESULTS

Sixty percent of the adolescents said they did not know if they were registered in the health system, and half of them had not used it. Time of residence was identified as a relevant factor for the effective use of some health benefits. Administrative barriers to access the health system were recognized, such as immigration status, perception of obligatory adult companionship, and experiences of discrimination in care. Specific needs were identified in sexual and reproductive health, such as access to condoms, and mental health care from specialists. As facilitators of access and use, experiences of proper treatment and the presence of the health sector in schools were highlighted.

CONCLUSIONS

Lack of information about the health system and various barriers to access and use by migrant adolescents were identified. Based on the results, general recommendations are proposed for the country and the region to improve the health of migrant adolescents.

Adolescent Friendly Services: quality assessment with simulated users

OBJECTIVE

To assess the quality of adolescent friendly health services.

METHODS

Qualitative assessment using the simulated user technique in first level clinics of Health Services of Morelos, Mexico, during 2018. Ten out of 17 facilities with non-exclusive adolescent friendly services were randomly selected. An additional facility with exclusive adolescent friendly services was included as an intensive subsample. Four adolescents served as simulated users interpreting different cases in the clinics. The total of 43 semi-structured exit interviews were conducted, and two nominal groups were made to assess the perceived quality from the adolescents’ perception of friendliness and experience. Thematic analysis of the data obtained was performed.

RESULTS

Staff attitude was highlighted as a key element in the adolescents’ experience. Failures were found, such as the existence of bureaucratic barriers to access, lack of signage in clinics, lack of privacy and confidentiality, failure of physical examination during the appointment and lack of monitoring of the reasons for appointment. The exclusive clinic for adolescents offered more appropriate friendly services compared with nonexclusive clinics.

CONCLUSION

Although the service is accessible in most of the clinics visited, it is still far from being friendly according to international recommendations. The exclusive clinic for adolescents stood out for having better structured mechanisms that can be implemented in nonexclusive clinics to improve the care process.